Doctors in London are nervously awaiting Thursday's launch of the long-delayed NHS IT upgrade.
Department of Health officials hope the £12bn scheme, which sees patients' records go online, will improve the sharing of information between GPs and hospitals, as well as allowing doctors to make treatment decisions based on accurate records rather than recollection.
But the initiative has proved controversial, with a trial of the system being described as a "heartache" and "hard work" by London's Royal Free Hospital.
Opposition politicians and campaigners have also blasted the scheme for wastefulness, delays, uneven implementation and concerns over data protection.
Patients' Association director Katherine Murphy said the system had "great potential for making care safer", but added that "confidentiality is incredibly important".
"We have heard from patients who have found it is being made increasingly difficult to opt out. That is completely unacceptable," she said.
The first London records are due to be uploaded in Southwark at the Princess Street Group Practice.
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"We are intending to opt-out all of our patients and offer them the opportunity to opt-in, because of security worries. As an alternative we are piloting opening individual patients' records to them through our own clinical system as they then have the PIN and password that allows them to control access and security. They will still have all the advantages of remote access to their notes. I am aghast at the potential security problems of the Spine and have personally opted out" – Name and address withheld